National Journal glaucoma / Национальный журнал глаукома
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Хориоидея при глаукоме
Get PDFThe pathogenesis of glaucomatous optic neuropathy has been linked to the blood supply of the optic nerve, specifically within the prelaminar part of the optic nerve head. As the blood supply of this region comes from the peripapillary choroid, the choroid has been implicated in the pathogenesis of glaucoma. However, the relationship between choroidal blood flow and glaucoma has not been yet definitively established by means of histologic examination, angiography and Doppler sonography. The development of an enhanced imaging technique for spectral domain optical coherence tomography (SD-OCT) has allowed for reproducible measurements of choroidal thickness and measurements of choroidal thickness that are more accurate than previously possible. Therefore, the SD-OCT may be capable of documenting those particular changes in the choroid that relate to glaucoma. Several reports have been published about choroidal thickness within the macula and peripapillary area in glaucoma patients. However, the results of these studies are controversial. The relationship between choroidal thickness and ocular perfusion pressure as well as the role of the choroid in primary angle-closure glaucoma development are also discussed in this review.Кровоснабжение зрительного нерва, особенно его преламинарной зоны, как полагают, имеет значение в патогенезе глаукомы. Поскольку преламинарная зона зрительного нерва получает кровоснабжение из перипапиллярной хориоидеи, то можно предположить, что хориоидея играет существенную роль в развитии глаукомы. Однако предыдущие исследования, включая гистологию, ангиографию и допплерографию хориоидеи, не дали полной информации по этому вопросу. Метод спектральной оптической когерентной томографии позволяет более точно исследовать хориоидею и получать воспроизводимые результаты. Это открывает новые возможности в регистрации тех изменений хориоидеи, которые связаны с развитием глаукомы. К настоящему времени опубликованы результаты нескольких исследований по определению толщины хориоидеи в макулярной и пери-папиллярной зонах при глаукоме указанным методом. Однако их результаты неоднозначны. В настоящем обзоре рассмотрены связь между толщиной хориоидеи и перфузионным давлением глаза, а также роль хориоидеи в развитии первичной закрытоугольной глаукомы
Гемодинамические нарушения в магистральных сосудах глаза и орбиты при эндокринной офтальмопатии как фактор риска развития оптической нейропатии
Get PDFНовые взгляды на развитие сочетанной патологии: первичной открытоугольной глаукомы и тромбоза ретинальных вен
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Анализ заболеваемости глаукомой населения Республики Башкортостан
Get PDFPURPOSE: Examine glaucoma incidence in the Republic of Bashkortostan (RB) over the 2010-2015 period.METHODS: The data of «Medical Information and Analytical Centre of the Ministry of Health of Bashkortostan Republic» for 2010-2015 was analyzed during the research. We calculated the level of general and primary incidence per 100 thousand population, growth rate, share of glaucoma in the structure of the eye diseases and preventive medical examination rate. Indicators of general and primary disease incidence in Bashkortostan in comparison with similar indicators in the Russian Federation (RF) in 2010-2015 were analyzed.RESULTS: Glaucoma incidence analysis showed an increase of its share in the structure of general and primary incidence among different population groups for 2010-2015. The study revealed general glaucoma incidence growth among general and adult population by 12.1% and 13.4% correspondingly compared to 2010. General incidence indicator decreased by 5.0% among the elderly population. Both primary incidence and preventive medical examination rate also increased in comparison with 2010. An increased primary disease incidence was marked in all age groups: among the entire population — by 48.6%, among the adult population — by 48.5% and among the elderly population — by 23.5%. Indicators of general and primary incidence in Bashkortostan were higher than national average.In 2015, in the Republic of Bashkortostan 7.3 patients per 1,000 general population, 9.3 patients among the adult population and 25.0 patients among older working age population were subjects to regular glaucoma check-up, which was higher than in 2010 by 21.7, 22.4 and 5.5% respectively.CONCLUSIONS: The research revealed an aggravating epidemiological situation with glaucoma in the Republic of Bashkortostan. General and primary incidence rates analysis showed negative trends in various demographic groups of this disease
Исследования оксигенации в офтальмологии
Get PDFOxygen content in body fluids and tissues is an important indicator of life support functions. A number of ocular pathologies, e.g., glaucoma, are of presumable vascular origin which means altered blood supply and oxygen circulation. Most oxygen is transported in blood bound to hemoglobin. When the blood is passing through the capillaries, oxygen releases, i.e., oxygenated hemoglobin converts into deoxygenated hemoglobin. This process is accompanied by the changes in spectral characteristics of hemoglobin which result in different colors of arterial and venous blood. Photometric technique for the measurement of oxygen saturation in blood is based on the differences in light absorption. Blood oxygen saturation is measured by oximetry. In medicine, the most common method is pulse oximetry which assesses tissue oxygenation. In ophthalmology, this technique was applied to study blood saturation in glaucoma and to analyze the efficacy of glaucoma therapy. Oxygen concentration can also be evaluated by measuring oxygen partial pressure, i.e., pressure from the dissolved oxygen in blood. In ophthalmological practice, this parameter was measured in anterior chamber fluid in glaucoma after instillations of hypotensive eye drops as well as in vitreous body near to the optic disc under various levels of intraocular pressure. Currently, retinal oximetry allows for the calculation of oxygen saturation in retinal blood vessels. This technique is based on the assessment of light absorption with blood depending on hemoglobin saturation with oxygen by analyzing spectral composition of light reflected from the retina. Oximetry of bulbar conjunctival and episcleral microvasculature can be performed as well. This technique allows for the evaluation of oxygen saturation in vessels which collect blood from the anterior segment and the characterization of anterior segment metabolism in a number of ocular pathologies and in the course of treatment
Влияние типа конъюнктивального разреза при первичной синустрабекулэктомии на метаболизм кислорода в зоне операции и ее гипотензивную эффективность
Get PDFНовые возможности дренажной хирургии рефрактерной глаукомы
Get PDFGlaucoma is a socially significant disease, which is consistently ranked first or second among causes of visual impairment and blindness. Difficulties with diagnosis verification, treatment algorithms, monitoring, patient compliance to treatment regimens that occur at a certain stage of therapy, as well as medication prescriptions inefficiency lead to progressive vision loss. Numerous surgical techniques often have limited effectiveness. Drainage use is aimed at reducing excessive scarring in filtration area and creating one or more paths of intraocular fluid resorption. The review presents currently existing approaches to refractory glaucoma drainage surgery. Different implant groups are described in details, including those reducing excessive scarring, intracameral drainages and Schlemm's canal implants. Current perceptions of viscocanalostomy and canaloplasty effectiveness in glaucoma surgery are recounted. The advantages of implants, designed to maintain the Schlemm's canal volume, are specified. NiTi is a promising new material for use in glaucoma drainage surgery. Technical characteristics of biocompatibility, possibilities of modern engineering and technical lasers for processing NiTi allow to use this material on microstructural level
Ингибиторы Rho-киназы - новые препараты местной гипотензивной терапии глаукомы
Get PDFThis review presents ROCK inhibitors - a new family of hypotensive drugs that lower intraocular pressure by enhancing trabecular outflow. It mentions a crutial role of the actin- myosin contractile system in resisting the aqueous humor outflow, and describes the effect that selective Rho-kinase inhibitors have on trabecular system contraction, laxation and, consequently, on the outflow volume. The article also enumerates several Rho-kinase inhibitors that are currently in the pipeline, such as Rhopressa™ (Phase III, “Aerie Pharmaceuticals”, USA), Roclatan™, Ar-12286 (Phase II, “Aerie Pharmaceuticals”, USA), K-115 (Phase III, “Kowa Pharmaceutical”, Japan), AMA0076 (Phase II, “Amakem Therapeutics”, Belgium). The review provides a short description of their mechanisms of action, such as the relaxation of trabecular meshwork that leads to increased outflow, mediated decrease in fluid production and lowering of episcleral venous pressure. It also describes the transient moderate adverse reactions, and gives a brief recount of conducted clinical trials of the new drugs
Влияние аналогов простагландинов на морфофункциональные характеристики сетчатки у пациентов с глаукомой после факоэмульсификации
Get PDFCataracts and glaucoma are the main reasons for visual acuity decrease among the eye diseases in people older than 50 years. Over 50% of patients with primary openangle glaucoma use local antihypertensives on a constant basis. In recent years, prostaglandin analogues (PA) have served as the drugs of choice for treating glaucoma. They improve the uveoscleral outflow of aqueous humor and have a high antihypertensive efficacy. On the other hand, since PA exhibit general properties of mediators of inflammation, they may induce vasodilation, increase vascular permeability and enhance promotion of exudative processes. In some cases this group of drugs may lead to blood-ocular and blood-retinal barriers breach that in turn may provoke the development of cystoid macular edema including early postoperative period after cataract extraction. The paper provides information on some studies relating to the impact of PA on the postoperative period after phacoemulsification. At present, there is no unequivocal opinion on this question